Quality over quantity: powering neuroimaging samples in psychiatry

• Published in: Neuropsychopharmacology (New York, N.Y.) N.Y.), 2024-11, Vol.50 (1), p.58-66
• Main Authors: Makowski, Carolina, Nichols, Thomas E., Dale, Anders M.
• Format: Article
• Language: English
• Subjects: 692/308/575; 692/53/2423; Behavioral Sciences; Biological Psychology; Brain - diagnostic imaging; Humans; Image processing; Medical imaging; Medicine; Medicine & Public Health; Mental Disorders - diagnostic imaging; Neuroimaging; Neuroimaging - methods; Neuroimaging - standards; Neurosciences; Pharmacotherapy; Population studies; Psychiatry; Psychiatry - methods; Psychiatry - standards; Psychiatry - trends; Research Design; Review Article; Sample Size; Translation
• ISSN: 0893-133X; 1740-634X; 1740-634X
• DOI: 10.1038/s41386-024-01893-4

Neuroimaging has been widely adopted in psychiatric research, with hopes that these non-invasive methods will provide important clues to the underpinnings and prediction of various mental health symptoms and outcomes. However, the translational impact of neuroimaging has not yet reached its promise, despite the plethora of computational methods, tools, and datasets at our disposal. Some have lamented that too many psychiatric neuroimaging studies have been underpowered with respect to sample size. In this review, we encourage this discourse to shift from a focus on sheer increases in sample size to more thoughtful choices surrounding experimental study designs. We propose considerations at multiple decision points throughout the study design, data modeling and analysis process that may help researchers working in psychiatric neuroimaging boost power for their research questions of interest without necessarily increasing sample size. We also provide suggestions for leveraging multiple datasets to inform each other and strengthen our confidence in the generalization of findings to both population-level and clinical samples. Through a greater emphasis on improving the quality of brain-based and clinical measures rather than merely quantity, meaningful and potentially translational clinical associations with neuroimaging measures can be achieved with more modest sample sizes in psychiatry.